scholarly journals Epilepsy and insular Grade II gliomas: an interdisciplinary point of view from a retrospective monocentric series of 46 cases

2009 ◽  
Vol 27 (2) ◽  
pp. E8 ◽  
Author(s):  
Luc Taillandier ◽  
Hugues Duffau
Keyword(s):  
Seizure Frequency ◽  
Point Of View ◽  
Favorable Effect ◽  
Surgical Removal ◽  
Extensive Experience ◽  
Who Grade ◽  
Grade Ii ◽  
Sequential Treatments ◽  
Few Data

OBJECTThere are few data in the literature concerning a multimodal approach to insular WHO Grade II gliomas (GIIGs) and the control of epilepsy after treatment. In this paper, the authors describe a monocentric series of 46 cases in which patients underwent various sequential treatments for insular GIIGs. On the basis of global results with regard to epilepsy, the respective interests in the various treatments are discussed.METHODSAvailable data on 46 patients harboring insular GIIGs were extracted from a local database of 288 GIIGs. The various therapeutic sequences were analyzed in parallel with the course of seizure frequency.RESULTSDespite the usual difficulties with seizure quantification in retrospective studies, the authors showed that 1) the negative course of seizure frequency was mostly connected to tumor progression, 2) surgery almost always had a favorable effect on epilepsy, and 3) chemotherapy had a mostly favorable effect with acceptable tolerance. The authors were unable to draw conclusions about the role of radiotherapy given the too few cases.CONCLUSIONSThis extensive experience with insular GIIGs tends to confirm interest in their surgical removal and supports interest in chemotherapy from an epileptological point of view.

scholarly journals IDH mutation status and role of WHO grade and mitotic index in overall survival in grade II–III diffuse gliomas

2015 ◽  
Vol 129 (4) ◽  
pp. 585-596 ◽  
Author(s):  
Adriana Olar ◽  
Khalida M. Wani ◽  
Kristin D. Alfaro-Munoz ◽  
Lindsey E. Heathcock ◽  
Hinke F. van Thuijl ◽  
...  
Keyword(s):  
Overall Survival ◽  
Mitotic Index ◽  
Idh Mutation ◽  
Who Grade ◽  
Mutation Status ◽  
Diffuse Gliomas ◽  
Grade Ii

A personal consecutive series of surgically treated 51 cases of insular WHO Grade II glioma: advances and limitations

2009 ◽  
Vol 110 (4) ◽  
pp. 696-708 ◽  
Author(s):  
Hugues Duffau
Keyword(s):  
Posterior Part ◽  
Surgical Removal ◽  
Consecutive Series ◽  
Glioma Surgery ◽  
Who Grade ◽  
Additional Surgery ◽  
Grade Ii ◽  
The Impact ◽  
Grade Ii Glioma

Object Few experiences of insular surgery have been reported. Moreover, there are no large surgical studies with long-term follow-up specifically dedicated to WHO Grade II gliomas involving the insula. In this paper, the author describes a personal consecutive series of 51 cases in which patients underwent surgery for an insular Grade II glioma. On the basis of the functional and oncological results, advances and limitations of this challenging surgery are discussed. Methods Fifty-one patients harboring an insular Grade II glioma (revealed by seizures in 50 cases) underwent surgery. Findings on preoperative neurological examination were normal in 45 patients (88%). All surgeries were conducted under cortico-subcortical stimulation, and in the case of 16 patients while awake. Results Despite an immediate postoperative worsening in 30 cases (59%), the condition of all but 2 patients (96%) returned to baseline or better. Postoperative MR imaging demonstrated that 77% of resections were total or subtotal. Ten patients underwent a second or third surgery, with no additional deficit. Forty-two patients (82%) are alive with a median follow-up of 4 years. Conclusions This is the largest reported experience with insular Grade II glioma surgery. The better knowledge of the insular pathophysiology and the use of intraoperative functional mapping allow the risk of permanent deficit to be minimized (and even enable improvement in quality of life) while increasing the extent of resection and thus the impact on the course of the disease. Therefore, surgical removal must always be considered for insular Grade II glioma. However, this surgery remains challenging, especially within the anterior perforating substance and the posterior part of the (dominant) insula. Additional surgery can be suggested in cases in which the first resection is not complete.

scholarly journals The role of up-front radiation therapy for incompletely resected pediatric WHO grade II low-grade gliomas1

2006 ◽  
Vol 8 (2) ◽  
pp. 166-174 ◽  
Author(s):  
Kavita K. Mishra ◽  
Dev R. Puri ◽  
Brian T. Missett ◽  
Kathleen R. Lamborn ◽  
Michael D. Prados ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Low Grade ◽  
Who Grade ◽  
Grade Ii

scholarly journals Glioblastoma multiforme as a secondary malignancy following stereotactic radiosurgery of a meningioma: case report

2019 ◽  
Vol 46 (6) ◽  
pp. E11 ◽  
Author(s):  
Jason J. Labuschagne ◽  
Dinoshan Chetty
Keyword(s):  
Glioblastoma Multiforme ◽  
Stereotactic Radiosurgery ◽  
Single Case ◽  
Case Reports ◽  
Rare Complication ◽  
Secondary Malignancy ◽  
Surgical Removal ◽  
Who Grade ◽  
Grade Ii ◽  
Who Grade Ii Meningioma

The documentation and exact incidence of stereotactic radiosurgery (SRS)–induced neoplasia is not well understood, with most literature restricted to single case reports and single-center retrospective reviews. The authors present a rare case of radiosurgery-induced glioblastoma multiforme (GBM) following radiosurgical treatment of a meningioma. A 74-year-old patient with a sporadic meningioma underwent radiosurgery following surgical removal of a WHO grade II meningioma. Eighteen months later she presented with seizures, and MRI revealed an intraaxial tumor, which was resected and proven to be a glioblastoma. As far as the authors are aware, this case represents the third case of GBM following SRS for a meningioma. This report serves to increase the awareness of this possible complication following SRS. The possibility of this rare complication should be explained to patients when obtaining their consent for radiosurgery.

scholarly journals Seizure response to temozolomide chemotherapy in patients with WHO grade II oligodendroglioma: a single-institution descriptive study

2018 ◽  
Vol 6 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Aya Haggiagi ◽  
Edward K Avila
Keyword(s):  
Disease Progression ◽  
Seizure Frequency ◽  
World Health ◽  
Low Grade ◽  
Inclusion Criteria ◽  
Who Grade ◽  
Seizure Reduction ◽  
Grade Ii ◽  
Health Organization

Abstract Background Tumor-related epilepsy (TRE) is common in patients with low-grade oligodendrogliomas. TRE is difficult to control despite multiple antiepileptic drugs (AEDs) in up to 30% of patients. Chemotherapy has been used for treatment to avoid potential radiotherapy-related neurotoxicity. This study evaluates the effect of temozolomide on seizure frequency in a homogeneous group with World Health Organization (WHO) grade II oligodendrogliomas. Methods A retrospective analysis was conducted of adult patients with WHO grade II oligodendrogliomas and TRE followed at Memorial Sloan Kettering between 2005 and 2015 who were treated with temozolomide alone either as initial treatment or for disease progression. All had seizures 3 months prior to starting temozolomide. Seizure frequency was reviewed every 2 cycles and at the end of temozolomide treatment. Seizure reduction of ≥50% compared to baseline was defined as improvement. Results Thirty-nine individuals met inclusion criteria. Median follow-up since starting temozolomide was 6 years (0.8-13 years). Reduction in seizure frequency occurred in 35 patients (89.7%). Improvement was independent of AED regimen adjustments or prior antitumor treatment in 16 (41%); of these, AED dosage was successfully reduced or completely eliminated in 10 (25.6%). Twenty-five patients (64.1%) remained on a stable AED regimen. The majority (n = 32, 82%) had radiographically stable disease, 5 (12.8%) had objective radiographic response, and 2 (5.2%) had disease progression. Conclusions Temozolomide may result in reduced seizure frequency, and permit discontinuation of AEDs in patients with WHO II oligodendroglioma. Improvement was observed irrespective of objective tumor response on MRI, emphasizing the importance of incorporating seizure control in assessing response to tumor-directed therapy.

RADT-27. EFFECTIVENESS ANALYSIS OF RADIOTHERAPY FOR INTRACRANIAL RECURRENT EPENDYMOMA

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi47-vi47
Author(s):  
Qingjun Hu ◽  
Mingyao Lai ◽  
Juan Li ◽  
Linbo Cai
Keyword(s):  
Survival Time ◽  
Rank Test ◽  
Who Grade ◽  
Radiotherapy Group ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Recurrent Ependymoma ◽  
Grade Ii

Abstract OBJECTIVE There is no standard treatment for recurrent ependymoma. This study aimed to investigated the role of radiotherapy in recurrent ependymoma. METHODS Retrospective analysis was performed on 49 cases of recurrent ependymoma diagnosed in Guangdong Sanjiu Brain Hospital from January 2008 to July 2020. Overall survival (OS) was calculated by Kaplan-Meier method and tested by Log-rank test. P < 0.05 was considered statistically significant. RESULTS The median age was 7 years (range:1-57 yrs). Nineteen patients were with ependymoma WHO grade II while 30 were with grade III, respectively. Recurrence treatment: 14 cases received re-surgery, 23 cases received radiotherapy, among them 16 cases received re-radiotherapy. To May, 2021, the median follow-up time was 35 months (range 3-153). Median PFS time was 17 months after initial diagnosis, median PFS time was 8 months after treatment to recurrence disease, Median OS time is 39 months, and median OS time is 20 months after recurrence. The median survival time for recurrence was 48 months vs. 11 months (P =0.001) in the radiotherapy group vs. non-radiotherapy group,res; Re-radiotherapy combined with chemotherapy vs reradiotherapy alone (0.194); RRT combined with anti-angiogenesis therapy vs. RRT alone (0.688). CONCLUSION Radiotherapy can prolong the survival time of recurrent ependymoma, and concurrent therapy as chemotherapy or anti-angiogenesis therapy with RT does not seem to improve the prognosis. Therefore, radiotherapy can be used as the main treatment for recurrent ependymoma.

scholarly journals P11.10 Role of hydroxyurea as an adjuvant treatment after gamma knife radiosurgery for atypical (WHO grade II) meningiomas

2016 ◽  
Vol 18 (suppl_4) ◽  
pp. iv67-iv68
Author(s):  
K. Abdel Karim ◽  
A. El Shehaby ◽  
R. Emad ◽  
W. Reda ◽  
M. El Mahdy ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Adjuvant Treatment ◽  
Gamma Knife Radiosurgery ◽  
Who Grade ◽  
Grade Ii
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